View Information Collection Request (ICR) Package
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Brief and OIRA conclusion
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IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0920-0572
ICR Reference No:
201502-0920-001
Status:
Historical Active
Previous ICR Reference No:
201501-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
CDC and ATSDR Health Message Testing System
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/30/2015
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/11/2015
Terms of Clearance:
Approved consistent with the following terms of clearance: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2018
36 Months From Approved
03/31/2015
Responses
55,575
0
55,575
Time Burden (Hours)
7,410
0
7,510
Cost Burden (Dollars)
0
0
0
Abstract:
CDC must communicate about hazards, outbreaks and other emergencies that present an urgent health threat to the public. Untested messages can waste communication resources and opportunities because the messages can be perceived as unclear or irrelevant. OADC-CDC requests an extension for the generic clearance for an expedited review of items to be used in health message testing to ensure the public will understand health messages and take recommended action.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
79 FR 69478
11/21/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 7477
02/10/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
34
IC Title
Form No.
Form Name
"Bring Your Brave" Campaign Messages for Young Women and Health Care Providers
0920-0572, 0920-0572, 0920-0572, 0920-0572
Screening Instrument for Young Women
,
Survey Instrument for Young Women
,
Screening Instrument for Health Care Providers
,
Survey Instrument for Health Care Providers
Air Quality Information Initiative
none
Recruitment screener
American Academy of Pediatrics Oral Health Toolkit Research and Message Testing
Antibiotic Use Campaign: Round 2 (R2) Concept/Materials Testing with Consumers
n/a, n/a, n/a, n/a, n/a
Screener for Consumers (Self-demanders and Self-expectors)
,
Screener for Consumers (Caregiver-demanders and Caregiver-expectors)
,
Pre-discussion Information Survey for Consumers (Self-demanders and Self-expectors)
,
Pre-discussion Information Survey for Consumers (Caregiver-demanders and Caregiver-expectors)
,
Online Focus Group Guide for Consumers
Antibiotic Use Campaign: Round 2 (R2) Concept/Materials Testing with Health Care Professionals
n/a, n/a, n/a
Screener for Health Care Professionals
,
Pre-Discussion Information Survey for Health Care Professionals
,
In-Depth Interview Guide for Health Care Professionals
Assess Perception and Use of CDC Guideline for Prescribing Opioids for Chronic Pain
none
CDC Prescription Opioid Physician Survey
Asthma Control Communication Materials Field Testing (NCEH)
none, none, none, none, none
Foduc Group Screener
,
Youth Rating Worksheet
,
Caregiver Rating Worksheet
,
Youth Comparison Worksheet
,
Caregiver Comparison Worksheet
Asthma Control Initiative Communication Messaging and Materials Development
none
Focus Group Screener
Be Antibiotics Aware Educational Message/Materials Assessment
n/a
Be Antibiotics Aware Consumer Survey (BAACS)
Bring Your Brave Campaign Message Testing
none
Bring Your Brave Campaign Testing Survey
CDC/NCEH TO21: Outdoor Air Quality Focus Group
Domestic Readiness Initiative on Zika Virus Disease
0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572
Attachment 4 - Provider Screener_1_13
,
Attachment 5 - Provider Survey_1_13
,
Attatchment 6 - FGPRScreener_1_13
,
Attachment 7 - FGPRGuide_1-13-17
,
ttachment2 - Consumer Screener for IDICONUS_1_13
,
Attachment 3 consumer IDI Guide_l1_13
Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials
NA, NA
Focus Group Screener
,
Focus Group Guide
Domestic Readiness Initiative on Zika Virus Disease: Year 2 Message & Materials Testing
NA, NA, NA, NA
Community Leader - Focus Group Screening Instrument
,
Men/Women Reproductive Age (18-49) - Focus Group Screening Instrument
,
Community Leader - Focus Group Guide
,
Men/Women Reproductive Age (18-49) - Focus Group Guide
Focus Group Research to Inform the Development of Mesages to change Social Norms
Att. F2, Att. F1
Att. F1 Dads book
,
Att. F2 Moms book
GenIC Testing of Spanish-language Messages for the National Diabetes
HEADS UP Audience Research Study
NA, NA
FOCUS GROUP SCREENER AND FOLLOW UP FOCUS GROUP SCREENER
,
FOCUS GROUP AND FOLLOW UP FOCUS GROUP INSTRUMENT
HMTS - Formative evaluation of Zika prevention strategies and messages among pregnant women and community leaders in Puerto Rico
NA, NA, NA, NA, NA, NA
Focus Group Discussion with Community Leaders in Puerto Rico to Explore Possible Actions for Preventing Zika
,
Focus Group Discussion with Pregnant Women in Puerto Rico to Explore Possible Actions for Preventing Zika
,
Focus Group Discussion with Pregnant Women in Puerto Rico To Test Zika Prevention Messages
,
In-depth Interview of Community Leaders in Puerto Rico to Explore Possible Actions for Preventing Zika
,
In-depth Interview of Pregnant Women in Puerto Rico to Explore Possible Actions for Preventing Zika
,
In-depth Interview of Pregnant Women in Puerto Rico To Test Zika Prevention Messages
HMTS - Message testing among important public audiences in Puerto Rico
NA
Intercept Interviews with Public Audiences in Puerto Rico to test Zika Prevention Messages
High Impact Prevention Message Testing (HIPMT)
NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA
Consumer Focus Group Guide
,
Consumer IDI Guide
,
Provider Focus Group Guide
,
Provider IDI Guide
,
Professional Focus Group Guide
,
Professional IDI Guide
,
Consumer - Brief Survey
,
Provider - Brief Survey
,
Professional - Brief Survey
,
Consumer - Screener
,
Provider - Screener
,
Professional - Screener
,
Consumer - Consent
,
Provider - Consent
,
Professional - Consent
,
Consumer Web Survey
,
Intercept Guide
,
Screener - Consumer Web Survey
,
Consent - Consumer Web Survey
,
Consent - Intercept Survey
Intercept Interviews with Travelers in Puerto Rico To Test Zika Prevention Messages
NA, NA
Intercept Interviews with Public Audiences in Puerto Rico To Test Zika Prevention Messages - English
,
Intercept Interviews with Public Audiences in Puerto Rico To Test Zika Prevention Messages - Spanish
Interim Assessment of Messages for the Prescription Drug Overdose Prevention, Awareness, and Knowledge Building Campaign
N/A
Screen Shots of the Prescription Drug Overdose Survey
Message Testing among Public Audiences in US Virgin Islands for Zika prevention
none
Intercept interview for message testing
Message Testing with Mothers for CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO)
n/a, n/a
Screener and Survey for Online Participants (content is provided in screen shots and Word)
,
Screener and Moderator's Guide for In-person Focus Group Participants
Message testing among partners of pregnant women in Puerto Rico
NA, NA
Intercept Interviews with Public Audiences in Puerto Rico to test Zika Prevention Messages - English
,
Intercept Interviews with Public Audiences in Puerto Rico to test Zika Prevention Messages - Spanish
Office of the Associate Director for Communication (OADC) Message and Material Feedback
NA, NA
OADC Message and Material Feedback Survey - Screener
,
OADC Message and Material Feedback Survey - Health Material Questions
Older Adult Mobility Planning Brochure
none
Participant Screener
Radiation Concepts/Comparison Message Testing
none, none
Interview Screener
,
Focus Group Screener
Re-entry Messaging Following a Radiation Emergency
Sepsis Campaign Development: Round 2 Concept/Materials Testing for Consumers
n/a
Screenshots of the Sepsis R2 Survey for Consumers
Sepsis Campaign Development: Round 2 Concept/Materials Testing for Healthcare Providers
n/a
Screenshots of the Sepsis Survey for Healthcare Professionals
Sepsis Educational Awareness Message/Materials Assessment - Consumers
none
Sepsis Assessment - Consumers
Sepsis Educational Awareness Message/Materials Assessment - HCP
none
Sepsis Educational Awareness Assessment
Skin Cancer Messages among Racial Ethnic Groups at Risk for Delayed Diagnosis, Advanced Disease and Lower Survival
N/A, N/A, N/A, N/A, N/A, N/A, N/A
Screener
,
Informed Consent and Rescreening Form
,
Focus Group Discussion Guide for African American Women
,
Focus Group Discussion Guide for Hispanic Women
,
Focus Group Discussion Guide for African American Men
,
Focus Group Discussion Guide for Hispanic Men
,
Digital Ad Response Sheet (completed during focus groups with men)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
55,575
55,575
0
0
0
0
Annual Time Burden (Hours)
7,410
7,510
0
-100
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
Burden change reverts estimated numbers back to original ICR; additional hours were added previously due to an unusually burdensome genIC.
Annual Cost to Federal Government:
$1,550,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Shari Steinberg 404 639-4942 sxw2@cdc.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
02/11/2015